Abstract Details

Title At-Home Transcranial Direct Current Stimulation (tDCS) for Teleinterventions: Safety and Tolerability with Remote Supervision

Topic Neuro-rehabilitation

Presentation(s) S10 - Neuro-rehabilitation: Neuromodulation (1:00 PM-1:12 PM)

Poster/Presentation
Number 001

Background

tDCS is a noninvasive brain stimulation technique investigated for a wide range of behavioral and clinical applications including to enhance rehabilitative outcomes. tDCS requires repeated daily administration for cumulative behavioral effects and clinical benefit. We developed a telehealth protocol, remotely supervised, for at-home access for daily repeated treatments.

Objective

To report the safety and tolerability of at-home remotely supervised transcranial direct current stimulation (RS-tDCS), including when paired with rehabilitation and extended periods of repeated administration.

Design/Methods We analyzed safety and tolerability data collected through standardized adverse events (AEs) reporting across our clinical trials utilizing our RS-tDCS protocol in participants with multiple sclerosis (MS) and other neurological conditions. Participants completed the tDCS sessions from home while monitored by study technicians in real time via videoconference. All daily at-home RS-tDCS sessions were 20 minutes in length, had stimulation intensities between 1.5 and 2.5 mA, and targeted either the dorsolateral prefrontal cortex (DLPFC, left anodal), the primary motor cortex (M1-SO, C3/C4 anodal) or the cerebellum. Interventions ranged from 10 to 60 RS-tDCS sessions repeated daily, five days per week, up to 12 weeks.

Results

Analyses included n=7,239 at-home RS-tDCS sessions from n=351 participants with neurological conditions. Participants were 18-78 years old and included also those with severe levels of neurologic disabilities. There were no serious AEs. None of the participants reporting pain greater than 7 during the study were discontinued, and session-limiting AEs were rare (27 events/0.004%). Most frequent reported AEs (active/sham) were tingling (61%/73%), followed by warmth sensation (38%/38%), and itching (34%/41%) and were not treatment-limiting. AEs frequency did not significantly change across repeated daily exposures (p>0.050). There was 96% completion rate of protocols administering >20 sessions of tDCS.

Conclusions At-home RS-tDCS offers many advantages for both research and patient care. RS-tDCS is safe, tolerable and feasible as a scalable teleintervention.

Authors/Disclosures
Giuseppina Pilloni, PhD (NYU Grossman School of Medicine) PRESENTER	Dr. Pilloni has nothing to disclose.
Pamela Best	Ms. Best has nothing to disclose.
Allan George	Mr. George has nothing to disclose.
Matthew Lustberg	No disclosure on file
	No disclosure on file
Lana Zhovtis Ryerson, MD (Jersey Shore University Medical Center)	Dr. Zhovtis Ryerson has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Zhovtis Ryerson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Zhovtis Ryerson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Zhovtis Ryerson has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Zhovtis Ryerson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Zhovtis Ryerson has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Zhovtis Ryerson has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Zhovtis Ryerson has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. The institution of Dr. Zhovtis Ryerson has received research support from Biogen. The institution of Dr. Zhovtis Ryerson has received research support from Genentech.
Lauren B. Krupp, MD, FAAN (NYU Langone Medical Center)	Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gerson Lerhman. Dr. Krupp has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for medscape. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NeuroLive. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai. Dr. Krupp has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Cleveland Clinic. Dr. Krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for MCIC. The institution of Dr. Krupp has received research support from Biogen. The institution of Dr. Krupp has received research support from National Multiple Sclerosis Society. Dr. Krupp has received intellectual property interests from a discovery or technology relating to health care.
Leigh E. Charvet, PhD (NYU Langone)	Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson & Johnson. Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. Dr. Charvet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for YBrain. Dr. Charvet has stock in Johnson&Johnson.